The treatment of facial veins can be achieved in various ways, with each method having its particular side effects and benefits. Sclerotherapy is a relatively simple and easy method to treat these vessels, generally with an acceptable side effect profile and minimal material requirement and cost. Facial veins occur in many individuals and may relate to estrogen levels, disease, or oral contraceptive pills. They also occur in a number of hereditary conditions such as poikiloderma and other essential telangiectasiae. The case history described outlines an unusual consequence of sclerotherapy to the face that may relate to the anatomy of the vessel, the sclerosant, neurovascular considerations, or the personal medical status of the patient. In this instance, the resolution was complete with treatment success, but this event was temporarily distressing to all involved, and to determine etiology may be of benefit in preventing further incidents.